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Anatomy 2 > Urinary System > Flashcards

Urinary System Flashcards

1
Q

How do the kidneys regulate different aspects of homeostasis?

A
  • Balance water with antidiuretic hormone (ADH)
  • Maintain blood plasma so molarity by controlling plasma ionic comp through aldosterone
  • maintain blood pressure and volume by releasing renin (low blood pressure)
  • regulate plasma pH to maintain acid-base balance
  • secrete erythropoietin to stimulate RBC production when low O2 levels are detected
  • activate vitamin D3 for calcium homeostasis
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2
Q

What are the functions of the urinary system?

A
  • Regulate many aspects of homeostasis through the kidneys and hormones (renin, ADH, calcitriol)
  • Eliminate metabolic waste products like nitrogenous wastes from protein synthesis, excess ions, toxins, and drugs
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3
Q

What are the primary structures of the urinary system and their functions?

A
  • Kidneys- form urine
  • Ureters- transport urine from kidneys to the bladder
  • Bladder- Stores urine
  • Urethra- excretes urine from bladder to outside of body
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4
Q

What are the major developmental aspects of the urinary system?

A
  • functional kidneys developed by the 12th week in utero
  • Fetus produces urine that adds to amniotic fluid ~week 13
  • newborn urinary system under developed (small bladder, not concentrated for 2-3 months postpartum, voids up to 40x/day)
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5
Q

How is blood supply impacted by the kidneys?

A
  • a quarter of the body’s total blood supply passes through the kidneys each minute
  • renal artery provides each kidney with arterial blood supply
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6
Q

What is the path of blood through the kidneys? (Know pathway starting from either end)

A

Aorta-> renal artery-> segmental artery-> interlobar artery-> arcuate artery-> cortical radiate artery-> afferent arteriole-> glomerulus (capillaries)-> efferent arteriole-> peritubular capillaries -> cortical radiate vein-> arcuate vein-> interlobar vein-> renal vein-> inferior vena cava

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7
Q

What are the major features of the kidney?

A
  • right kidney is slightly lower than the left due to the positioning of the liver
  • renal hilum is a medial indentation where structures (ureters, renal blood vessels, and nerves) enter or exit the kidneys
  • adrenal gland sits atop each kidney
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8
Q

Explain the basics of what occurs during a kidney transplant

A
  • Two surgeries take place
  • First is removing diseased kidney, second is giving transplant
  • Kidney only lasts ~12 years
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9
Q

What are some of the major causes of kidney disease?

A
  • Lack of blood flow to kidneys
  • severe dehydration
  • Type I and Type 2 Diabetes Melkite’s
  • Infections
  • Genetics
  • Street Drug Use
  • Long term use of non-steroidal anti-inflammatory drugs (NSAIDs like ibuprofen and naproxen)
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10
Q

What are some of the major symptoms of kidney disease?

A
  • Hypertension
  • nausea
  • vomiting
    -loss of appetite
  • decreased mental acuity
  • proteinuria
  • weakness
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11
Q

What are kidney stones?

A
  • Hard mass that forms from crystals in the urine usually stopped by natural chemicals in the urine
  • most often made of calcium oxalate (Can sometimes be calcium phosphate, Struve the, Uris acid, cystine stones, and more)
  • causes can be dietary, genetic, excessive dehydration, high protein diet, gout
  • having one kidney stone makes it more likely to happen again
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12
Q

What is a nephron?

A
  • Structural and functional units of the kidney
  • responsible for forming urine
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13
Q

Describe the structure of a nephron

A
  • renal tubules that extend from the glomerular capsule and end at the collecting duct
    • made of: glomerular (Bowman’s) capsule, proximal convoluted tubule (PCT), loop of Henle, distal convoluted tubule (DCT)
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14
Q

What is the renal corpuscle?

A
  • Composed of Bowman’s Capsule (site of filtration) and the glomerulus (tuft of capillaries)
  • Site of filtration (blood is filtered from glomerular capillaries into Bowman’s capsule to start forming urine)
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15
Q

What are the different types of nephrons?

A
  • Cortical nephrons (located mostly in the cortex of the kidney and makes up most nephrons)
  • Juxtamedullary nephrons (found at boundary of the cortex and dip deep into the medulla- located next to the corpuscle)
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16
Q

What are the different capillaries associated with the nephron?

A
  • glomerulus
  • peritubular capillary bed (wrap all around and are involved in gas exchange)
  • Vasa recta (only present in juxta medullary nephrons; specialized capillaries that run along the loop of Henle)
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17
Q

What is the glomerulus?

A
  • Knot of capillaries
  • Capillaries are covered with podocytes from the renal tubule
  • sits within a glomerular capsule
  • Under high pressure to force fluid and small solutes out of blood and into the glomerular capsule
  • Fed and drained by arteriole (afferent feeds; efferent drains)
  • Specialized for filtration
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18
Q

What is GFR and how is it impacted by BP?

A
  • Glomerular filtration rate
  • Increased by increase in BP due to increased capillary hydrostatic pressure
  • Relatively constant with increases in BP due to intrinsic regulation until BP reaches 180 mmHg
  • Decreases with decreases in BP (<80mmHg); decreases water filtered + urine excretion
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19
Q

What is the afferent arteriole?

A
  • Arises from a cortical radiate artery
  • Feeds the glomerulus
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20
Q

What is the efferent arteriole?

A
  • Receives blood that has passed through the glomerulus (Drains glomerulus)
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21
Q

What are the peritubular capillary beds?

A
  • Arise from efferent arteriole
  • Regular, low pressure capillaries
  • Adapted for reabsorption instead of filtration
  • Cling close to the renal tubule to reabsorb some substances from tubules
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22
Q

What are the collecting ducts?

A
  • Receives urine from many nephrons
  • Run through the medullary pyramids
  • Delivers urine into the calyces and renal pelvis
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23
Q

What type of process is urine formation?

A
  • an active recall process
  • Occurs at the glomerulus
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24
Q

What are the steps of urine formation?

A

1) Glomerular Filtration (always first)-> Water and solutes smaller than proteins are forced through the capillary walls and pores of the glomerular capsule into the renal tubule
2) Tubular Reabsorption -> Water, glucose, amino acids, and needed ions are transported out of the filtrate into the tubule cells and then enter the capillary blood
3) Tubular Secretion-> H+, K+, creatinine, and drugs are removed from the peritubular blood and secreted by the tubule cells into the filtrate
*Steps 2 and 3 are interchangeable

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25
Q

What are the sites of filtration, reabsorption, and secretion in a kidney?

A
  • Filtration occurs in the glomerular capsule
  • Reabsorption occurs in the proximal tubule, distal tubule, the Loop of Henle, and collecting duct
  • Secretion occurs in the proximal tubule and distal tubule
    *See slide 23 for diagram
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26
Q

Describe the basic renal processes

A
  • Glomerular filtration occurs from the glomerulus to Bowman’s capsule
  • Reabsorption is from tubules to peritubular capillaries
  • Secretion is from peritubular capillaries to tubules
  • Excretion is from tubules out of body
    *See slide 24 for diagram
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27
Q

What is the process that occurs in glomerular filtration?

A
  • It is a mostly none selective passive process dictated by the size of the solute
  • Water and solutes smaller than proteins are forced through capillary walls
  • Proteins and blood cells are normally too large to pass through the filtration membrane
  • Filtrate is collected in the glomerular capsule and leaves via the renal tubule
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28
Q

What is the average GFR/day?

A

125 mL/min or 180 L/day

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29
Q

What happens to GFR during kidney failure?

A

The kidney can only filter 2x a week so toxins build up and have to be filtered all at one
- extremely exhausting process helped externally by dialysis (expensive)

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30
Q

What is the process of reabsorption?

A
  • Movement from tubules into peritubular capillaries (returned to blood)
  • Mostly occurs in proximal tubule
  • most is not regulated
  • barrier reabsorption is epithelial cells of renal tubules and endothelial cells of capillary (minimal)
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31
Q

What is the process of tubular reabsorption?

A
  • peritubular capillaries reabsorb useful substances (water, glucose, amino acids, ions)
  • Mostly active process
  • Most often occurs in the proximal convoluted tubule
  • Some materials are not reabsorbed (nitrogenous waste products, Uris acid from nuclei acid breakdown, creatinine associated with creating metabolism in muscles)
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32
Q

How does reabsorption occur in the proximal tubule?

A
  • Proximal tubule is a mass reabsorber
  • non-regulated reabsorption
  • brush border has a large surface area due to microvilli
  • approximately 70% water and sodium reabsorbed
    -100% glucose reabsorbed (with a normal diet)
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33
Q

What is the process of tubular secretion?

A
  • Reabsorption in reverse
  • the movement of materials from peritubular capillaries into the renal tubules
  • important for getting rid of substances not already in the filtrate
  • materials left in the renal tubule move toward the ureter
  • Secreted substances (potassium, hydrogen ions, choline, creatinine, penicillin)
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34
Q

What is excretion rate?

A
  • amount of substance excreted = amount filtered + amount secreted - amount reabsorbed
  • amount excreted depends on rate of filtration, secretion rate, and reabsorption rate
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35
Q

Describe the renal handling of solute

A
  • if amount of solute excreted per minute is less than filtered load, solute was reabsorbed
  • if amount of solute excreted per minute is greater than filtered load, solute was secreted (ex. Meds are secreted)
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36
Q

What is clearance (mL/min)?

A
  • Volume of plasma from which a substance has been removed by kidneys per unit time
  • clearance of inulin (not same as insulin; is a carbohydrate) can be used to measure GFR (measures glomerular function)
  • Calculation: excretion rate/conc. In plasma
  • can be performed if a doctor suspects a pathology
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37
Q

What is renal plasma flow rate and how is it measured?

A
  • it’s the clearance of a substance freely filtered, fully secreted, and not reabsorbed
  • Measured with para-aminohippuric acid (PAH)
  • Measures blood flow through kidney to find out if it’s hindered at some point
  • avg. = 550-650 mL/min
  • amount excreted = amount contained in volume of plasma that entered the kidneys
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38
Q

Describe the structure of the urinary bladder

A
  • smooth, collapsible, muscular sac
  • temporarily stores urine
    • moderately full bladder ~12.5cm + holds ~500mL of urine
  • Trigone is a triangular region of the bladder base
    • has three openings (2 from ureters coming in + 1 from urethra leaving)
  • prostate gland surrounds neck of bladder in males
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39
Q

What is the structure of the urinary bladder wall?

A
  • 3 layers of smooth muscle collectively called the detrusor muscle
  • mucosa made of transitional epithelium that allows that bladder to not increase internal pressure
  • walls are thiick and folded in an empty bladder
  • can expand significantly without increasing internal pressure due to transitional epithelium
  • External urethral sphincter under voluntary control
  • internal urethral sphincter under involuntary control
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40
Q

What is the process of micturition (voiding/urination)?

A
  • urine formed in renal tubules
  • fluid drains into renal pelvis and into ureter
  • ureters lead to bladder + store urine until excretion
  • both sphincter muscles open to allow voiding
  • internal urethral sphincter is relaxed after stretching of the bladder
  • pelvic splanchinic nerves initiate bladder to go into reflex contractions
  • urine is forced past the internal urethral sphincter and personal feels urge to void
    external urethral sphincter must be voluntarily relxed to void
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41
Q

What are the major characteristics of urine?

A
  • 1-1.8 L of urine produced in 24 hours (depending on fluid intake)
  • urine + filtrate are different
    • filtrate contains everything blood plasma does except proteins
    • urine is what remains after filtrate has lost most of its water, nutrients, and necessary ions
    • urine contains notrogenous wastes + substances that aren’t needed
  • yellow color due to pigment urochrome (from destruction of hemoglobin) + solutes
  • slightly aromatic
  • varying pH but usually acidic (~6)
  • specific gravity of 1.001-1.035
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42
Q

What is specific gravity

A

It is the density of urine relative to water

43
Q

Why are multivitamins not recommended?

A
  • Not regulated by FDA
  • things like Vitamin C tablets are water soluble + are just peed out (filtered by kidney)
44
Q

What solutes are usually found in urine?

A
  • sodium + potassium ions
    -urea, uric acid, creatinine
  • ammonia
  • bicarbonate ions
  • things we have excess of
45
Q

What solutes are not normally found in urine?

A
  • glucose
  • large proteins
  • RBCs
  • hemoglobin
  • white blood cells
  • bile
46
Q

What is glycosuria?

A
  • glucose in urine
  • Nonpathalogical causes: Excessive intake of sugary foods
  • Pathalogical causes: Diabetes mellitus
47
Q

What is proteinuria

A
  • proteins in urine
  • Nonpathological causes: Physical exertion, pregnancy (preeclampsia)
  • pathalogical causes: Glomerulonephritis, hypertension
48
Q

What is pyuria?

A
  • WBCs in urine
  • Causes: UTI
49
Q

What is hematuria?

A
  • RBCs in urine
  • Causes: Bleeding in urinary tract due to trama, kidney stones, infection
50
Q

What is hemoglobinuria?

A
  • Hemoglobin in urine
    -Causes: Transfusion reaction, hemolytic anemia
51
Q

What is bilirubinuria?

A
  • bile pigment in urine
  • Causes: liver disease (hepatitis) from viral infection
52
Q

How do the kidneys impact blood composition?

A
  • BC depends on diet, cellular metabolism, and urine output
  • Kidneys maintain BC through excretion of wastes, maintaining water balance of the blood, maintaining electrolye balance of the blood, ensuring proper blood pH
53
Q

What is osmolarity’s role in reabsorption

A
  • No osmotic force for water to move between fluid compartments
  • kidneys compensate for changes in osmolarity of extracellular fluid by regulating water reabsorptiion
  • Water reabsorption occurs in the proximal tubule (passive based on osmotic gradient, follows solute reabsorption, primary solute that follows water is sodium
  • osmolarity of body fluids = ~300 mOsm/L
54
Q

What is obligatory water loss and why is it necessary?

A
  • Minimum volume of water that must be excreted in the urine per day
  • 440mL a day (minimum)
  • lost through breathing, skin, urine, more
  • necessary to eliminate non-reabsorbed solutes
  • max osmolarity urine= 1200-1400 mOsm/L (concentrated)
  • min urine osmolarity= 100mOsm/L (dilute)
    -some solute must be excreted
55
Q

How is water balance maintained?

A
  • dilute urine in larger volumes is produced if water intake exceeds need (can lead to hyponatremia)
  • less urine that is concentrated is produced when a person is dehydrated (hypernatremia)
  • proper concentrations of various electrolytes must also be present
56
Q

What is hyponatremia?

A
  • Overhydrating
  • When blood volumbe doesn’t have enough sodium
  • Water intoxication
57
Q

What is hypernatremia?

A
  • too much sodium in blood volume due to dehydration
58
Q

Why is the counter-current multiplier in the Loop of Henle important?

A
  • establishes an osmotic gradient that is dependent on the Loop of Henle
  • requires a lot of ATP to maintain it
59
Q

What role does the descending limb of the Loop of Henle have in the osmotic gradient?

A
  • it’s permeable to water/aquaporins
  • no transport of Na+, Cl-, or K+
60
Q

What role does the ascending limb of the Loop of Henle have in the osmotic gradient?

A
  • impermeable to water
  • transport of Na+, Cl1, and K+/pumps
61
Q

What is the result of the counter-current multiplier?

A
  • Fluid in proximal tubule at 300 mOsm/L
  • Osmolarity of fluid in descending limb increases as it descends (becomes more concentrated)
  • Osmolarity of fluid in ascending limb decreases as it ascends (dumping off ions + vasa recta will pick some up)- becomes more dilute
62
Q

What is the purpose of the vasa recta?

A

-prevents dissipation of the osmotic gradient while supplying nutrients + removing waste by picking up extra water
- blood in vasa recta removes wter leaving the loop of Henle (prevents water from diluting conc gradient)

63
Q

How is water and electrocute reabsorption regulated?

A
  • Osmoreceptors create loop
64
Q

What are osmoreceptors?

A
  • cells in the hypothalamus
  • react to changes in blood composition by becoming more active as osmolarity increases, fire more APs
  • leads to release of antidiuretic hormone (ADH)
  • ADH decreases osmolarity (part of negative feedback response
65
Q

What is the negative feedback loop that regulates water and electrolyte reabsorption?

A

Water reabsorption-> plasma osmolarity/ circulatory BV-> signals baroreceptors and osmoreceptors-> osmoreceptors signal ADH synthesis + baroreceptors signal ADH release-> signals kidney collecting duct receptors-> cAMP-> aquaporin-2 -> water reabsorption

66
Q

When is ADH released?

A
  • when osmolarity is high
  • dependent on osmotic-gradient established by counter-current multiplier
67
Q

What is water permeability dependent on?

A
  • Water channels
  • aquaporin-3 (present in basolateral membrane)
  • aquaporin-2 (present in apical membrane when ADH is present in blood)
  • both must be present for water to be reabsorbed into peritubular capillary
68
Q

What happens to the permeable membrane in the presence of ADH?

A

ADH stimulates insertion of water channels (aquaporin-2) into apical membrane
- water can permeate membrane and be reabsorbed by osmosis
- Max osmolarity urine (1200-1400 mOsm/L

69
Q

How is ADH release regulated?

A
  • released from neurosecretory cells originating in the hypothalamus
  • primary stimulus for release is increased osmolarity (osmoreceptors) of plasma
  • Decreased blood pressure (baroreceptors) and decreased BV
70
Q

Draw out the negative feedback loop of ADH regulation

A

Osmolarity of extracellular fluid increases-> signals osmoreceptors in hypothalamus-> activity of neurosecretory cells in hypothalamus increases-> signals posteriors pituitary-> ADH secretion increases-> signals kidneys-> water reabsorption increases-> water excretion decreases-> conservation of body water

71
Q

Draw out the negative feedback loop that occurs when decreased blood pressure stimulates ADH release

A

MAP decreases-> signals arterial baroreceptors-> frequency of APs conducted to CNS decreases-> activity of neurosecretory cells in hypothalamus increases-> signals posteriors pituitary-> ADH secretion increases-> signals kidneys-> water reabsorption increases-> water excretion decreases-> conservation of BV

72
Q

Draw out the negative feedback loop that occurs when BV decrease stimulates ADH release

A

BV decreases-> signals cardiac and venous baroreceptors-> frequency of APs conducted to CNS decreases-> activity of neurosecretory cells in hypothalamus increases-> signals posterior pituitary-> ADH secretion increases-> signals kidneys-> water reabsorption increases-> water excretion decreases-> conservation of BV
- decreased BV causes decreased MAP

73
Q

What is another name for ADH?

A
  • Vasopressin
  • vasopressin receptor gene expressed in brain linked to monogamy + pair bonding in various species
  • different variations of gene are linked to varying degrees of commitment to a mate
  • environment + water access impacts monogamy bc limited resources means monogamy is Morse resourceful option to keep species going
  • monogamy less necessary with ample water source
74
Q

What is the renin-angiotensin mechanism?

A
  • mediated but juxtaglomerular apparatus of the renal tubules
  • when cells of JG apparatus are stimulated by low BP, enzyme renin is released into blood by granular cells of the kidney
  • release of renin begins cascade of events that lead to release of angiotensin II
  • net result is increase in BV + BP
75
Q

What is angiotensin II?

A

Causes vasoconstriction to increase MAP, increase in thirst, increase in sympathetic activity, and leads to aldosterone and ADH release
- results in increased BV + BP
- original stimulus was low BP

76
Q

How does aldosterone affect sodium reabsorption?

A
  • increases sodium reabsorption, water follows sodium
77
Q

What is aldosterone?

A
  • steroid hormone (cholesterol is precursor for synthesis)
  • increases osmolarity
  • increases BV which increases BP
  • secreted from adrenal cortex
  • acts on principal cells of distal tubules and collecting ducts )increases number of Na+/K+ pumps on basolateral membrane; increases number of open Na+ and K+ channels on apical membrane
78
Q

Draw out the mechanisms of aldosterone release and sodium reabsorption

A

1) BP falls-> 2) renin is released + signals angiotensinogen to release angiotensin I-> 3) angiotensin converting enzyme (ACE) signals release of angiotensin II-> 4) angiotensin II signals aldosterone release from adrenal cortex-> aldosterone causes salt retention which causes BP to rise
-> angiotensin II can also stimulate ADH release which causes BP to rise without aldosterone
-> angiotensin II can also cause vasoconstriction which increases BP

79
Q

How does aldosterone impact K+ while increasing Na+ reabsorption?

A

Increases K+ secretion

80
Q

What does Angiotensin II do?

A
  • works to increase BP and BV
  • stimulates aldosterone + ADH release
  • is a vasoconstrictor + increases MAP
  • stimulates sympathetic activity
  • increases thirst
81
Q

How does reabsorption regulation primarily occur?

A

By hormones

82
Q

How does ADH regulate water and electrolyte reabsorption?

A
  • prevents excessive water loss in urine
  • causes kidney’s collecting ducts to reabsorb more water
  • levels go up at night and is inhibited by alcohol
83
Q

How is water and electrolyte reabsorption regulated by diabetes insipidus?

A
  • occurs when ADH isn’t released
  • leads to huge outputs of dilute urine without drinking a lot of water
  • frequent bed wetting is a symptom
  • rare
84
Q

How is water and electrolyte reabsorption regulated by aldosterone?

A
  • increased osmolarity
  • regulates sodium ion content of ECF
  • sodium is the electrolyte most responsible for osmotic water flow
  • aldosterone promotes reabsorption of Na+ and water follows Na+
85
Q

What is atrial natriuretic peptide?

A
  • a peptide hormone
  • released from atrium in response to stretch of wall
  • increases sodium excretion
  • antagonist of aldosterone and ADH (decreases BP + BV)
86
Q

Draw out the negative feedback loop of ANP

A

Increased plasma volume-> increased atrial wall stretch-> increased ANP secretion-> afferent arteriole dilation + efferent arteriole contraction + renin secretion decreases-> glomerular capillary pressure increases + aldosterone decreases-> GFR increases + Na+ reabsorption decreases-> Na+ excretion increases

87
Q

How does angiotensin II impact aldosterone and ADH?

A

Increases aldosterone + ADH secretion and thirst

88
Q

How does ANP impact aldosterone and ADH secretion?

A

Decreases both

89
Q

Is it more important to fix osmolarity issues or blood volume issues first?

A

osmolarity is more important bc it affects how the nervous system functions

90
Q

What are the major acids and bases produced by the body?

A
  • Phosphoric acid, lactic acid, fatty acids, CO2 forms carbonic acid
  • ammonia/base
91
Q

What are the three main lines of defense against acid-base disturbances?

A
  • most balance maintained by kidneys (by maintaining H+ and bicarbonate)
  • buffering of H+ ions (almost instant)
  • respiratory compensation (takes minutes)
  • renal compensation (hours to days)
92
Q

What are the three major chemical buffer systems?

A

-bicarbonate buffer system: most important ECF buffer
- phosphate buffer system: incracellular
- protein buffer system
- hemoglobin (buffer in erythrocytes)

93
Q

What are buffers?

A

Molecules that react to prevent dramatic changes in H+ conc.
- bind to H+ when pH drops
- release H+ when pH rises

94
Q

What is the respiratory defense mechanism for acid-base balance?

A
  • CO2 in the blood converted to bicarbonate ion + transported in the plasma
  • CO2 increases amount of carbonic acid leading to more H+ ions
  • excess acid can be blown off with release of CO2 from lungs
  • respiratory rates rise/fall depending on changing blood pH
  • hypoventilation decreases pH (more carbonic acid)
  • hyperventilation increases pH (less carbonic acid)
95
Q

What is respiratory compensation?

A
  • 2nd line of defense
  • take minutes to have effect
  • regulates pH through varying ventilation
  • increase ventilation-> decrease CO2-> decrease H+/increase pH
  • decrease ventilation-> increases CO2-> increase H+/decrease pH
96
Q

What is renal compensation?

A

-3rd line of defense
- regulate excretion of H+ and bicarbonate in urine
- urine pH varies from 4.5-8.0 depending on acid base balance
- regulate synthesis of new bicarbonate in renal tubules

97
Q

How does renal compensation respond when blood pH falls and increases acidity?

A

1) increased secretion of hydrogen ions
2) increased reabsorption of bicarbonate
3) increased synthesis of new bicarbonate

98
Q

How does renal compensation respond to increased pH and alkalinity?

A

1) decreased secretion of H+ ions
2) decreased reabsorption of bicarbonate
3) decreased synthesis of new bicarbonate

99
Q

What are some respiratory disturbances to acid-base balance?

A
  • CO2 is a source of acid + issues w/ controlling breathing rate may lead to changes in blood plasma pH
  • Normal Pco2 arterial blood = 40mmHg
  • Sources of CO2: cellular respiration
  • Output of CO2: through respiratory system
  • increase in plasma CO2-> respiratory acidosis
  • decrease in plasma CO2-> respiratory alkalosis
100
Q

What is respiratory acidosis?

A

-increased CO2-> increased H+-> decreased pH
- caused by hypoventilation due to a pathology
- compensation: renal
1) increase H+ secretion
2) increase bicarbonate reabsorption
3) increase synthesis of bicarbonate
- no effect on increased CO2

101
Q

What is respiratory alkalosis?

A

Decreased CO2-> decreased H+-> increased pH
- caused by hyperventilation due to a pathology
- compensation: renal (effect on decreased CO2)
1) decrease H+ secretion
2) decrease bicarbonate reabsorption
3) decrease bicarbonate synthesis

102
Q

What is metabolic acidosis?

A
  • decrease pH through something other than carbon dioxide (usually low free bicarbonate)
  • caused by high protein diet, height fat diet, heavy exercise, severe diarrhea, renal dysfunction/failure
  • renal and respiratory compensation unless cause is renal
  • respiratory compensation is increased ventilation-> decreased CO2
    -renal compensation
    1) increase H+ secretion
    2) increase bicarbonate reabsorption
    3) increase synthesis of new bicarbonate
103
Q

What is metabolic alkalosis?

A
  • Increase pH through something other than CO2 (usually high free bicarbonate)
  • excessive vomiting
    -consumption of alkaline products
  • renal dysfuntion/failure
  • compensation is renal and respiratory
  • respiratory compensation is decrease ventilation-> increase CO2 + neutralize alkalosis
  • renal compensation
    1) decrease H+ secretion
    2) decrease HCO3- reabsorption
    3) decrease synthesis of new bicarbonate
104
Q

How should acid-base disturbances be evaluated?

A

See slide 81 for chart to memorize + practice

Anatomy 2 (7 decks)

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